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AN 

INAUGURAL  DISSERTATION 

ON  THE 

PERSPIRABLE  FLUIDS 

OF  THE 

HUMAN  BODY; 

SUBMITTED  TO  THE  PUBLIC  EXAMINATION  OF  THE 

FACULTY  OF  PHYSIC 

t?KDER  THE  AUTHORITY    OF    THE    TRUSTEES    OF  COLUMBIA  COLLEGE, 
IN  THE   STATE  OF  NEW-YORK, 

The  Right  Rev.  BENJAMIN  MOORE,  D.D.  President  j 

FOR  THE  DEGREE  OF 

DOCTOR  OF  PHYSIC, 

On  the  <■")*  Dav  of  November,  1802. 


BY  RICHARD  L.  WALKER, 

Of  New-York. 


The  plague  Is  not  produced  ivithin  us,  but  arises  from  external  causes. 
Sancforiusf  Med.  Static.  Aphorism  12^* 


NEW-YORK: 


Printed  by  T.  &  J.  Swords,  Printers  to  the  Faculty  of  Physic 
of  Columbia  College. 

1802. 


TO 

The  Hon.  DE  WITT  CLINTON, 
RICHARD  S.  KISSAM,  M.D. 

AND 

EDWARD  MILLER,  M.D. 

THIS 

DISSERTATION 

Is  most  respectfully  dedicated. 


TO 

SAMUEL  BORROWE,  M,D, 

Sir, 

JL  he  time  set  apart  for  the  completion  of  my  medical  edu- 
cation being  now  terminated,  it  is  with  a  heart  overflowing 
with  the  tenderest  emotions  that  I  view  my  separation  from 
you  in  the  capacity  of  a  pupil.  In  this  separation,  however, 
I  am  supported  by  the  pleasing  reflection,  that  your  efforts 
will  never  be  wanting  to  promote  my  future  improvement 
and  usefulness. 

Having  experienced  so  much  of  your  goodness  hitherto, 
I  cannot  but  hope  that  your  exertions  to  wrest  me  from 
the  whirlwind  of  thoughtless  dissipation  will  be  kindly  con- 
tinued. 

If  I  have  not  improved  in  a  manner  equal  to  your  wishes, 
it  cannot  be  charged  to  your  neglect;  and  if  my  improve- 
ments had  even  exceeded  the  most  sanguine  expectations  of 
my  friends,  it  would  be  a  return  of  but  small  consideration 
for  your  faithfulness  and  attention. 

In  whatever  situation  accident  or  chance  may  place  me, 
I  shall  pray  that  Heaven  may  for  ever  confer  upon  you  an 
uninterrupted  course  of  peace,  happiness  and  success. 

Permit  me  to  say,  that,  during  my  residence  at  the  New- 
York  Hospital  as  House-Surgeon,  I  was  treated  with  that 
politeness  and  affability  by  the  visiting  surgeons  and  physi- 
cians, which  justly  claims  my  grateful  thanks. 

To  the  Governors  of  the  Hospital  I  make  grateful  and 
heartfelt  acknowledgments.     These  gentlemen  always  dis- 


(     6     ) 

played  a  disposition  to  cover  the  indiscretions  of  inexperienced 
youth  with  the  mantle  of  benevolence,  and  evinced  their 
friendship  by  a  favourable  construction  of  my  conduct. 

I  have  to  regret,  that  neither  opportunity  nor  language  is 
afforded  me  equal  to  my  obligations  to  the  several  Medical 
Professors. 

It  would  here  be  a  pleasing  task  to  take  a  view  of  the  state 
of  medical  learning  in  Columbia  College,  but  the  limits  which 
I  have  prescribed  to  myself  will  not  permit.  I  will,  however, 
observe,  that  our  medical  school  has  sustained  an  irreparable 
loss,  by  the  removal  of  that  learned  and  sound  philosopher. 
Dr.  MiTCHiLL,  The  young  gentlemen  of  the  College 
sincerely  mourn  his  absence,  and  think  it  will  be  long  a  suhr, 
ject  of  regret  to  the  Students  of  Medicine.  I  do  not  mean 
to  censure  the  proceedings  of  the  Trustees,  nor  in  any  man-* 
ner  whatever  to  inquire  into  the  causes  or  motives  of  the 
removal  of  that  gendeman.  But  there  is  no  doubt  of  their 
having  struck  oiF  from  the  catalogue  of  professors  a  great 
scientific  guide,  who  always  ably  pointed  out  the  road  to 
the  candidate  for  fame,  and  was  eminently  calculated  to 
bend  the  tender  mind  of  youth  to  improvement  and  useful- 
ness. 

These  are  not  mere  compliments  lavished  by  flattery,  but 
truths  extorted  by  the  justice  due  to  such  an  exalted  cha«» 
racter. 

With  high  respect  and  esteem, 

I  acknowledge  myself  your  hunjble  servant, 

KICHARD  L.  WALKER. 


AN 

INAUGURAL  DISSERTATION 

ON    THE 

PERSPIRABLE  FLUIDS 

OF   THE 

HUMAN  BODY, 


JL  HIS  important  function  of  living  beings  may 
be  advantageously  considered  in  three  points  of 
view^  to  wit: 

I.  As  respects  the  physiology  of  perspiration, 
ox  its  condition  during  the  continuance  of  health. 

II.  That  part  of  the  function  which  relates  td 
its  pathology,  or  its  state  during  disease. 

III.  Such  alterations  as  the  perspired  fluids 
undergo  by  chemical  action,  after  secretion^ 
changing  to  offensive,  and  often  to  noxious^  and 
even  pestilential  compositions. 


SECTION  I. 

Of  the  Perspiration  in  a  State  of  Health, 
IT  is  discovered  by  anatomy  that  the  large 
arteries  of  the  body  divide  and  subdivide  until 


(     8     ) 

they  become  almost  inconceivably  small  tubes  ^ 
they  are  so  wonderfully  minute  that  they  escape 
the  sharpest  sight,  and  when  divided,  as  in  a  fresh 
wound,  present  to  our  view  nothing  but  an  ap- 
pearance of  gore.  Injections,  skilfully  thrown 
into  the  vessels  of  the  dead  subject,  duly  prepar- 
ed, have  demonstrated  the  wonderful  intertex- 
ture  of  them  which  exists  in  every  part.  These 
hollow  pipes,  destined  to  conduct  the  blood 
through  the  body^  circulate  that  vivifying  fluid 
to  the  viscera,  to  the  organs  of  sense,  to  the 
brain,  to  the  muscles,  and  even  to  the  bones,  in 
the  requisite  quantity,  for  the  wants  and  uses  of 
these  respective  parts.  To  the  exterior  surface 
of  the  body  there  is  also  a  large  distribution  of 
the  vessels  which  transmit  the  blood.  During 
its  passage  from  the  right  ventricle  of  the  heart 
through  the  pulmonary  artery,  and  back  again  to 
the  left  auricle  through  the  pulmonary  veins,  this 
ruddy  fluid  undergoes  several  striking  changes ; 
it  loses  its  dark  or  purple  colour,  and  turns  to  a 
bright  or  crimson;  it  acquires  caloric  from  the 
decomposed  oxygen  gas  of  the  atmosphere,  and 
becomes  sensibly  warmer.  This  caloric,  conveyed 
along  with  the  vital  current,  through  all  its  chan- 
nels, imparts  warmth  to  the  whole  frame,  and 
thus  sustains  animal  heat  even  in  the  extreme 
parts.  During  its  passage  through  the  lungs, 
the  blood  also  receives  a  portion  of  oxygen  and 


(     9     ) 

light ;  these  mingling  with  the  sanguine  current, 
are  the  peculiar  agents  in  striking  the  bright  co- 
lour, and  of  turning  the  blood  to  an  animal  oxyd. 
And  while  this  process  is  going  on,  the  chyle 
lately  received  from  the  thoracic  duct,  and  not 
yet  effectually  incorporated  with  the  blood,  is  so 
completely  mingled  as  to  be  fairly  assimilated  with 
its  mass. 

In  passing  through  the  pulmonic  vessels  the 
blood  also  loses  something;  a  portion  of  its  phlo- 
giston passes  off,  and,  uniting  with  a  part  of  the 
oxygenous  air  within  the  bronchia,  forms  the 
oxyd  of  phlogiston  or  Water.  And  a  portion  of 
the  superfluous  carbone  passing  off  and  combine 
ing  with  another  part  of  the  bronchial  oxygen^ 
turns  to  carbonic  acid.  The  former  of  these, 
%^olatilized  by  caloric,  turns  to  halitus  or  watery 
vapour ;  while  the  latter,  operated  upon  by  the 
same  agent,  is  converted  to  carbonic  acid  gas. 
Both  of  these  are  known  to  be  formed  plentifully 
during  the  respiratory  process. 

Thus,  while  we  breathe  we  receive  into  our 
lungs  some  beneficial  agents,  to  wit,  chyle,  oxy- 
gen, light  and  heat;  and  we  part  with  some 
whose  existence  in  too  great  quantity  would  in- 
jure us,  phlogiston  and  carbone.  By  these  means 
the  venous  blood  is  changed  to  arterious;  and 
beino^  thus  chars^ed  with  both  stimulant  and 
nutritive  materials,  it  is  carried  by  the  left  ven* 
s 


(     10     ) 

tficlc  of  the  Jieart  into  the  aorta,  to  excite,  warm^ 
^nd  nourish  every  part  of  the  body. 

From  this  fluid  circulating  through  the  arteries 
and  veins  all  -the  secretions  of  the  body  are  de- 
rived. It  contains  the  elements  or  material^ 
whence  the  bile,  semen,  saliva,  tears,  lymph> 
urine  and  other  secreted  humours  are  formed  j 
and  from  the  same  source  proceed  the  fluids 
which  exhale  from  every  pore  and  transuding 
orifice  of  the  skin.  This  exterior  covering  is 
remarkably  supplied  with  blood  vessels;  and 
by  the  instrumentality  of  these,  a  very  large 
quantity  of  the  aqueous  part  of  the  blood  is  car- 
ried off  into  the  surrounding  air.  While  this 
function  is  going  on,  the  effete  and  vapid  por- 
tions of  the  blood  are  discharged  from  the  vessels, 
and  no  longer  remain  within  them  to  overcharge 
and  oppress  the  constitution;  while  the  super- 
abundant caloric  is  carried  off",  converted  from  ^ 
sensible  into  a  latent  state,  whereby  the  body  is 
rendered  cooler,  an  equilibrium  of  warmth  i^ 
preserved,  and  feverishness  prevented. 

These  secreted  fluids  are  of  three  kinds :  1st. 
That  which  takes  place  from  the  whole  surface 
of  the  skin,  called  Cuticiilar  Ferspiration;  2d. 
The  discharge  from  the  trachea  and  bronchia? 
denominated  iht  Pulmonary  Evaporation;  and, 
3d.  Those  fluids  which  proceed  from  sores  and  ul- 
cers, known  by  the  name  of  Purulent  Discharges. 


(  11  ) 

On  each  of  these  I  shall  make  sbtne  remarks  in 
succession. 

1 .  Of  Ciiticular  Perspiration, 

Physicians  seem  to  have  been  a  long  tififfe  igno- 
fant  of  the  quantity  and  extent  of  this  evacua- 
tion. If  \vas  known,  indeed,  that  occasionally 
the  human  body  discharged  a  considerable  quan- 
tity of  watery  fluid  by  sweat;  but  until  the  time 
of  Sanctorius,  the  doctrine  of  insensible  perspi- 
ration seems  not  to  have  been  understood. 

This  discerning  physician  first  ascertained,  by 
Weight,  the  quantity  of  humours  which  the  living 
body  lost  through  the  perspiratory  pores.  For 
this  purpose  he  ascertained  by  the  balance  how 
much  food  and  drink  he  took  in,  and  how  much 
Was  discharged  sensibly  by  the  different  excretory 
outlets:  And  having  found  that  the  measurable 
and  palpable  excreta  fell  considerably  short  of 
the  ingesta,  he  concluded  that  the  principal  part 
of  the  deficient  portion  was  carried  off  by  the 
cuticular  exhalation. 

This  discharge  from  the  surface  of  the  skin  has 
been  divided  into  two  kinds.  1st.  The  Insensi- 
ble or  Sanctorian  Perspiration.  2d.  The  Sensi- 
ble Perspiration,  or  Sweat. 

Of  tJie  Insensible  Ferspiration. 

When  the  cold  edge  of  a  polished  razor,  or 
other  bright  metal,  is  applied  to  the  surface  of 


(      12     ) 

the  skin  in  dry  winter  weather,  the  insensible 
perspiration  can  be  sometimes  seen  to  condense 
on  the  side  of  the  instrument:  it  even  seems  to 
be  protruded  from  the  body  with  considerable 
force.  When  horses  are  driven  violently  in  very 
cold  weather,  their  insensible  perspiration  is  con- 
densed by  the  ambient  air,  and  changed  to  visi-^ 
ble  vapour.  This  insensible  perspiration  can  al- 
so be  smelled  to  considerable  distances  in  certain 
cases :  for  example ;  when  exhaling  from  the  skin 
of  a  Negro  it  is  frequently  very  rank  and  offen- 
sive 5  and  even  from  the  most  delicate  body,  it  is 
strong  and  odorous  enough  to  be  scented  by  dogs. 
A  spaniel  will  follow  his  master's  track  among  a 
thousand  men.  In  this  probably  he  distinguishes 
some  peculiar  effluvium  not  emitted  by  any  other 
man;  and  sportsmen  remark  that  a  pack  of 
hounds  will  pursue  a  fox  very  ^well  when  running 
several  rods  to  leeward  of  that  animal's  track. 
The  wind,  in  this  case,  seems  to  waft  the  per-, 
spired  matter  to  their  nostrils. 

Thus  it  appears  that  there  is  an  exhalation 
from  the  animal  skin  of  considerable  weight 
and  peculiar  flavour :  from  this  the  shirts  and 
garments  next  the  skin  acquire  their  peculiar 
taint  and  foulness.  If  a  shirt  be  worn  next  the 
skin  of  an  healthy  person,  who  perspires  only, 
"but  without  exuding  sweat,  in  a  sensible  form, 
it  gradually  grows  unclean.     This  foulness  is  im^ 


(     IS     ) 

parted  to  it  from  the  skiri;,  and  to  the  skin  it  is 
derived  from  the  secretory  arteries;  whatever, 
therefore,  the  exhaling  vessels  impart  to  the  cu- 
tis vera  is  communicated  to  the  epidermis,  and 
from  this  latter  to  the  shirt,  drav^ers,  stockings, 
or  other  garment  next  to  the  body.  By  a  long 
series  of  wearing  in  contact,  the  cuticle  and  gar- 
ment not  only  grow  foul,  but  become  very  un- 
comfortable and  disagreeable  to  the  cutis  vera, 
which  is  highly  sensible.  Hence  arises  irritation 
of  the  surface,  with  sometimes  an  appearance  of 
pimples  in  various  parts.  Sometimes  the  confin- 
ed perspiration  excites  fretting  and  chafing  of 
the  skin;  and  not  unfrequently  a  too  long  con- 
finement of  it  upon  the  unclean  body  gives  rise 
to  the  itch,  or  increases  the  predisposition  to  that 
disease. 

The  uncomfortableness  of  having  the  exhaled 
fluids  of  the  skin  thus  incessantly  condensed  upon 
it,  has  led  to  the  practice  of  anointing  with  oil 
to  counteract  their  degeneracy  to  poison,  and  of 
purifying  with  alkalies  to  remove  them  entirely 
away. 

That  sensation  which  is  imparted  to  the  hu- 
man skin  by  unction  with  oil,  is  far  more  agree- 
able to  it  than  that  which  is  communicated  by  its 
own  excretions.  Indeed,  a  quantity  of  oiiy  or 
greasy  matter  is  secreted  by  the  healthy  skin,  and 
feesmears  its  surface.     Those  parts  of  the  body 


(     H    ) 

which  are  not  clothed  nor  washed,  give  ample 
proof  of  this :  the  hairy  scalp  is  always  supplied 
with  an  adipose  secretion  evident  to  any  one; 
and  the  like  obtains  in  the  other  parts  of  the 
skin.  Savage  nations,  who  are  scantily  clothed 
and  wrapped  in  furs  and  mantles  of  skins,  daub 
themselves  with  fat  or  oil  to  remove  the  disagree* 
able  sensations  occasioned  by  their  own  filth,  and 
they  find  great  relief  and  comfort  in  it:  to  a 
person  accustomed  to  clean  linen,  this  seems 
an  extraordinary  custom;  but  it  was  and  is  of 
great  utility  among  people  who  employed  a  dif- 
ferent dress  from  that  which  is  commonly  worn 
in  more  refined  life :  indeed,  so  strongly  were 
many  of  the  ancients  attached  to  these  greasy 
applications,  that  they  made  use  of  them  at 
length  for  the  purposes  of  luxury.  Their  un- 
guents were  highly  perfumed;  they  expended 
great  sums  in  the  purchase  of  them;  and  there 
was  a  class  of  persons,  called  latroalipt^,  who 
made  it  a  profession  to  apply  and  rub  them  on ; 
even  in  the  time  of  our  Saviour  precious  oint- 
ments were  in  use. 

The  employment  of  oil  after  bathing,  and  to 
soften  the  skin  and  limbs  of  the  athletse  and  others 
devoted  to  gymnastic  exercises,  evince  the  care 
and  assiduity  with  which  they  were  applied  in 
ancient  times;  nor  is  it  to  be  doubted  that  the 
extreme  unction  recommended  by  St,  James  to- 


(     15     ) 

be  applied  to  a  person  desperately  sick,  might 
have  been  serviceable  by  a  medical  as  well  as  a 
spiritual  operation. 

Where  a  more  accurate  system  of  cleanliness 
than  could  be  procured  by  oily  and  greasy  things 
was  desired,  water  was  employed;  and  hence 
we  derive  the  practical  benefits  of  frequent  wash- 
ing of  the  body  among  many  nations  of  the 
earth.  And  where  few  clothes  are  worn,  as 
among  the  natives  of  some  parts  of  Africa,  and 
of  the  warm  South  Sea  Islands,  washing  with 
water  will  answer  all  the  purposes  of  cleansing 
the  skin  and  keeping  it  comfortable  and  healthy ; 
but  where  it  is  fashionable  to  cover  all  t^e  parts 
of  the  body,  except  the  face  and  hands,  with 
clothing,  the  perspired  matter  cannot  escape  free- 
ly into  the  atmosphere,  but  must  be  entangled 
ifi  the  texture  of  the  garments ;  the  dress  grows 
rapidly  foul,  and  water,  in  order  to  make  them 
clean  and  healthy,  must  be  sharpened  by  soaps, 
leys,  and  alkaline  salts.  Hence  we  become  ac-^ 
quainted  with  the  qualities  of  the  insensible  per- 
spiration, not  commonly  evident  in  the  first  in- 
stance per  se,  but  tincturing  the  cuticle  and  the 
garments,  and  in  process  of  time  vitiating  them 
with  the  most  foul  and  unhealthy  taints. 
Of  the  Sensible  Perspij^ation,  or  Sweat. 

When  the  body  is  exposed  to  more  than  ordi- 
i\ary  heat,  or  is  made  to  undergo  exercise  more 


(     16     ) 

severe  than  usual,  the  surface  of  the  skin  grows 
moist,  and  if  the  heat  or  exercise  be  continued^ 
it  grows  wet  by  the  effusion  of  a  watery  fluid  ; 
this  either  overspreads  the  cuticle  in  the  form  of 
dew,  or  gathers  and  trickles  down  in  the  con- 
sistency of  large  drops ;  these  are  often  so  copious 
as  to  fall  from  the  forehead  and  face  to  the 
ground,  and  to  render  the  clothes  which  enwrap 
the  body  as  w^et  as  if  they  had  been  dipped  in 
water. 

This  effusion  is  what  is  properly  called  sweat. 
It  is  said  to  have  been  employed  as  the  token  of 
exertion,  exposure  and  toil,  when  man  forfeited 
his  innocence  and  fell  into  a  sinful  state.  Phy-* 
siologically  considered,  sweating,  when  moderate, 
has  several  salutary  effects;  it  relieves  the  body 
from  too  large  a  mass  of  circulating  fluids,  which, 
if  kept  for  ever  in  the  vessels,  would  injure  by  in- 
ducing a  dangerous  plethora.  It  has  a  happy: 
tendency  to  relieve  the  kidneys  and  bladder  front 
secreting  and  carrying  off  excessive  quantities  of 
urine;  for,  generally  speaking,  there  is  a  great 
sympathy  between  the  skin  and  kidneys.  When 
sweat  is  copious,  the  quantity  of  urine  is  propor- 
tionally small;  and  when  the  cuticular  discharge 
is  lessened,  the  secretion  by  the  kidneys  suffers  a 
corresponding  increase:  by  this  correspondence 
of  the  parts  to  each  other  great  advantage  is  gain- 
ed, and  the  wear  and  tear  of  the  urinary  passages 


(     17     ) 

are  so  far  lessened  or  prevented ;  and  this  economy 
is  the  more  remarkable,  as  in  men  the  urinary 
organs  are  among  the  first  to  fail,  or  become  unfit, 
through  natural  decay,  to  perform  their  proper 
functions. 

Sweating  also  answers  another  important  pur- 
pose; it  cools  the  body,  and  thereby  obviates  the 
disagreeable  consequences  of  the  animal  heat  ac- 
cumulating in  the  lungs.  Suppose  it  to  be  true 
that  a  gallon  of  atmospheric  air  is  deprived  of 
its  oxygen  by  a  healthy  man  in  the  course  of  a 
minute;  one  third  of  this  air  is  supposed  to  be 
oxygenous  gas;  in  this  gas,  a  great  quantity  of 
caloric  exists,  though  concealed  in  a  latent  state : 
to  this  latent  caloric,  the  oxygenous  and  even  the 
atmospheric  air  owe  their  permanent  elasticity; 
but  in  the  function  of  respiration  the  oxygenous 
gas  is  decomposed;  and  while  its  heat  and  light 
pass  through  the  membranes  and  vessels  of  the 
lungSj  to  mingle  with  the  blood  and  render  it  arte- 
tious,  its  caloric,  now  converted  from  a  latent  to  a 
sensible  state,  accompanies  the  vital  and  crimson 
current,  and  conveys  warmth  to  every  part  of  the 
body,  however  remote.  Thus  the  process  of 
breathing  turns  the  latent  heat  of  oxygenous  air 
to  sensible  heat,  and  bestows  it  upon  the  living 
body,  vivifying  and  cherishing  the  inward  parts, 
and  thence  travelling  to  the  exterior  surface. 

This  decomposition  of  oxygenous  air,  and  the 


(      IS     ) 

consequent  evolution  of  caloric,  goes  on,  unremit* 
tingly,  during  the  times  both  of  sleeping  and  wak-^ 
ing.  The  quantity  of  caloric  extricated  witliin 
the  lungs  is  prodigious.  So  great  a  quantity,  and 
so  high  ■  a  degree  of  it  is  collected,  that  unless 
some  discharge  or  outlet  was  provided  for  its  sur- 
plus, the  most  dangerous  consequences  v^^ould 
€nsue ;  but  the  bounty  of  the  Creator  has  provided 
such  an  outlet.  Every  cuticular  pore  or  duct 
discharges  a  portion  of  insensible  perspiration, 
and  at  times  pours  forth  a  quantity  of  sweat,  which 
conveys  from  the  system  inordinate  quantities  of 
heat. 

The  insensible  perspiration,  like  other  vapo- 
rifle  fluids,  derives  its  aeriform  quality  from  the. 
latent  heat  which  it  contains  :  the  quantity  of  this 
is  very  considerable,  and  the  whole  of  it  is  de- 
rived from  the  sensible  heat  of  the  skin.  In  the 
process  of  evaporation,  therefore,  there  is  a  large 
abstraction  of  ttie  sensible  heat  of  the  body,  and 
this  changing  into  a  latent  state,  goes  off  with  the 
sanctorian  halitus,  and  produces  the  sensation  of 
coolness  or  cold  upon  the  surface  from  which  it 
escaped. 

What  happens  to  the  perspiration,  happens 
eventually  to  sweat:  though  some  of  it  may  be 
absorbed  by  the  lymphatics,  the  greater  part  of 
it,  when  not  entangled  by  the  clothing,  gradually 
changes  to  a  vaporific  form  >  in  doing  so  it  takes 


(      19     ) 

Up  a  great  proportion  of  sensible  caloric,  and  ren- 
ders it  latent;  and  to  this  operation  is  to  be  ascrib- 
ed the  coolness,  and  even  cold  experienced  by  a 
person  who  sits  still,  especially  in  a  current  of  air, 
after  having  been  brought  into  a  profuse  sv^eat 
by  preceding  exercise.  By  these  means  is  the 
human  constitution  enabled  to  dispose  of  the 
superfluous  caloric  which  would  otherwise  accu- 
mulate and  continually  overheat,  and  eventually, 
perhaps,  consume  the  body.  The  inconvenience 
of  defective  perspiration  may  be  judged  of  by  the 
troublesome  effects  of  the  partial  accumulation  of 
heat,  during  the  hot  fit  of  an  intermitting  fever, 
and  of  the  rapid  cessation  of  it  when  sweat  breaks 
out. 

The  qualities  of  sweat,  when  chemically  exa^ 
mined,  seem  to  be  nearly  the  same  with  those 
of  the  insensible  perspiration.  Indeed,  the  latter 
appears  to  differ  from  the  former  but  in  degree, 
being  only  a  more  gentle  and  moderate  evacu^ 
ation  of  the  §ame  kind, 

2.  Of  the  Evaporation  or  Respiratian  from  the 
Lungs. 
It  has  been  computed  that  the  area  of  all  th^ 
ramifications  of  the  wind-pipe,  its  branches  and 
cells  in  the  lungs,  is  equal  to  the  area  of  the  whole 
external  surface  of  the  body:  these  are  distributed 
throughout  that  viscus  in  such  great  numbers, 


(     20     ) 

that  the  calculation  does  probably  not  go  beyond 
the  truth :  into  these  openings  within  the  thorax, 
the  atmospheric  air  is  freely  admitted  through  the 
mouth  and  glottis,  and  agitates  them  with  an  aU 
ternate  rising  and  depression.  Hence  these  in- 
ternal extensive  surfaces,  visited  and  ventilated  so 
constantly  and  completely,  are  considered,  in  fact, 
as  external  surfaces  affected  hy  air. 

Like  the  external  parts  of  the  body,  these  in-^ 
ternal  surfaces  of  the  lungs  exhale  a  watery 
vapour;  this  is  so  considerable  in  quantity  as  to 
be  very  perceptible  in  the  form  of  mist  in  cool 
weather;  and  when  the  air  is  very  cold  in  northern 
regions,  during  the  rigour  of  winter,  this  halitus 
turns  to  ice  on  the  bed-clothes  near  the  mouth 
and  nostrils,  or  even  freezes  into  icicles  in  the 
same  vicinity.  During  the  warmth  of  summer, 
this  watery  vapour  flies  off  in  a  form  less  evident 
indeed  to  the  eye,  but  still  capable  of  imparting 
its  moisture  to  any  bibulous  and  attractive  mate^. 
rial.  It  is  not  certain  what  the  quantity  thrown 
off  from  the  lungs  may  actually  amount  to,  but 
there  can  be  no  doubt  that  it  is  equally  copious 
with  the  exhalation  from  the  whole  of  the  cuti-? 
cular  surface. 

It  is  probable  that  this  secretion  originated? 
from  two  sources : 

1st.  A  part  of  it  is  in  all  probability  furnished 
from  the  bronchial  arteries.    They  seem  to  termi- 


(     21     ) 

nate  in  glandular  orifices  or  excretory  ducts,  or 
open  mouthed  exhalents,  as  the  blood  vessels  of 
the  skin  do^  and  there  can  be  no  reasonable 
doubt  that  they  perform  a  similar  function.  As  far 
then  as  the  bronchial  vessels  contain  and  convey 
bloodj  may  they  be  considered  as  furnishing  their 
quantum  of  perspired  matter  in  the  form  of  pul* 
monary  halitus.  There  is  also  the  strongest  ana- 
logy to  support  a  belief,  that,  as  far  as  their  powers 
extend,  the  bronchial  arteries  are  concerned  in 
preparing  perspirable  matter,  exactly  as  the  arte* 
ries  of  the  skin  are  5  but  these  arteries  are  too 
small  to  secrete  the  whole  of  the  pulmonary  hali* 
tus:  the  quantity  of  blood  which  they  convey  is 
not  sufficient  to  afford  so  large  an  amount  of  aque* 
ous  vapour;  therefore,  in  the  economy  of  the 
animal  frame,  it  is  wisely  provided,  that  the  lungs 
may  furnish  an  additional  quantity  of  halitus  or 
perspiration  by  another  process. 

2d.  The  other  part  of  the  halitus  of  the  lungs  is ' 
probably  formed  by  a  chemical  process.  Among 
the  researches  of  modern  science,  there  is  scarce- 
ly a  more  brilliant  discovery  than  that  of  the  phy^ 
sical  constitution  of  water ;  they  who  have  made 
experiments  on  the  subject  declare  that  if  eighty- 
five  parts  of  oxygen  are  chemically  combined 
with  fifteen  of  phlogiston  (hydrogen),  the  product 
will  be  clear  and  pure  water;  and  the  common 
modes  by  which  they  are  brought  into  this  strict 


(     22     ) 

connection  are  the  processes,  1st.  Of  inflamma- 
tion, where  the  phlogiston  of  blaze,  combined 
with  a  portion  of  atmospheric  oxygen,  turns  to 
water;  and,  2d.  Of  electrical  explosion,  wherci 
the  artincial  spark,  or  the  natural  lightning,  pass-^ 
ing  through  mixtures  of  inflammable  and  oxy- 
genous gases,  brings  them  into  contact,  by  form-^, 
ing  the  gaseous  oxyd  of  phlogiston  or  water. 

But  in  the  animal  body  there  seems  to  be 
another  mode  of  forming  water.  By  means  o£ 
vascular  agency  in  the  living  machine,  the  con-? 
stituent  parts  of  water  are  made  so  to  approx- 
imate as  to  be  within  the  attractive  distance  of 
each  other,  and  the  consequence  of  such  coalition 
is  water.  Now,  if  it  can  be  shown  that  oxygen, 
and  phlogiston  exist  in  the  lungs,  and  come 
within  reach  of  each  other,  there  will  be  no  dif- 
ficulty in  comprehending  how  they  may  contri- 
bute towards  the  formation  of  pulmonic  halitus. 

The  blood  gathered  from  all  parts  of  the  body 
in  the  vena  cava,  and  flowing  back  to  the  right 
auricle  of  the  heart,  is  loaded  with  a  great  sur- 
plusage of  phlogistic  (hydrogenous)  matter,  which 
the  good  of  the  constitution  requires  to  be  thrown 
off  in  part,  or  disposed  of.  The  retention  of  too 
much  of  this  would  tend  to  deteriorate  the  health 
of  the  animal,  wdiose  blood  w^as  thus  overcharged 
with  phlogiston,  or  the  basis  of  water. 

To  remedy  this  inconvenience  the  pulmonary. 


(     23     ) 

Structure  Is  remarkably  vascular,  open  and  porous*; 
and  through  outlets  or  passages  too  small  for 
blood  and  ordinary  fluids  to  pass,  the  phlogiston 
can  go  off  in  the  most  ready  and  easy  manner^ 
and  through  this  vascular  and  membranous  com- 
pass it  seems  actually  to  make  its  escape  from 
the  venous  blood,  w^ithout  producing  the  smallest 
disorganization  or  disturbance. 

But  if  this  v^^as  all,  the  phlogiston  so  exhaling 
from  the  blood  of  the  vena  cava  now  circulating: 
through  the  pulmonary  arteries,  v^ould  combine 
with  caloric,  and  escape  through  the  glottis  in 
the  form  of  inflammable  air.  But  there  is  another 
provision  in  this  case;  oxygenous  air  is  inspired 
through  the  mouth  and  nostrils,  and  penetrates  the 
innermost  recesses  of  the  lungs.  Here  this  vivify- 
ing gas,  meeting  with  nascent  phlogiston,  in  the 
act  of  escaping  from  the  blood,  unites  with  it  m 
the  most  intimate  connection,  and  thus  forms  an 
additional  quantity  of  water.  This  portion  of  water, 
added  to  that  produced  by  ordinary  secretion^ 
makes  up  the  amount  of  the  pulmonic  halitus. 

The  water,  so  formed  in  the  bronchial  extre- 
mities of  the  wind-pipe,  does  not  remain  long  in 
a  Jiuid  form ;  for  the  heat  of  the  thoracic  region 
is  great  enough  almost  instantly  to  convert  it  to 
2l  vaporific  or  gaseous  state;  and  in  this  form  it 
piingles  with  the  unconsumed  and  refluent  por- 
tion of  inhaled  atmosphere^  and  passes,  during 


(     24     ) 

the  act  of  expiration,  through  the  natural  outlets^ 
to  mingle  with  the  great  external  ocean  of  air. 

The  halitus,  so  produced  by  a  two-fold  pro- 
cess, contributes  to  the  preservation  of  health  iit 
nearly  the  same  manner  that  the  perspiration  and 
sweat  do.  It  evacuates  superfluous  humours;  if 
relieves  the  urinary  organs;  and,  by  carrying 
away  redundant  caloric,  tends  to  keep  the  body 
cool  and  comfortable. 

It  is,  however,  always  to  be  remembered,  that 
the  water  so  formed  by  synthesis,  instantly  be- 
comes the  menstruum  and  vehicle  of  various  ani- 
mal matters,  which  impart  to  the  halitus  the  pe- 
culiar qualities  for  which  it  is  distinguishable* 
In  these  particulars  it  has  a  near  resemblance  to 
the  cutaneous  perspiration. 

3.  Of  the  Fluids  secreted  from  Sores  and  Ulcers* 

Where  the  skin  has  been  removed  by  wounds^ 
ulceration,  or  otherwise,  the  injured  and  denuded 
vessels  do  not  dry  up ;  on  the  contrary,  they  pour 
forth  a  larger  quantity  of  fluids  than  they  effused 
in  their  healthy  state.  Some  part  of  these  are  re- 
absorbed, and  some  portion  turn  to  a  scab,  but  a 
greater  portion  of  this  secretion  evaporates  and 
escapes  into  the  surrounding  atmosphere. 

Every  person  who  approaches  a  patient  labour- 
ing under  abscess  or  ulcer,  can  distinguish  by  the 


(     25     ) 

smell  that  the  exhalation  is  considerable,  and 
oftentimes  extends  to  the  distance  of  many  feet^ 
and  more  particularly  surgeons  and  dressers  know 
what  great  quantities  of  humours  are  frequently 
discharged  from  sores  of  this  description.  So  great 
are  they,  in  many  instances,  as  to  taint  the  air  of 
the  room  vdiere  the  patient  lies,  and  to  make 
washing  and  ventilation  absolutely  necessary  to 
keep  the  apartments  clean  and  wholesome. 

Finding  that  contradictory  accounts  had  been 
published  of  the  qualities  of  this  purulent  dis- 
charge from  sores,  I  availed  myself  of  my  oppor- 
tunities, as  House  Surgeon  of  the  New- York  Hos- 
pital, to  make  some  experiments  on  the  subject. 
Some  had  affirmed  it  to  be  an  alkali^  while  others 
had  declared  it  to  be  an  acid.  My  experiments 
have  led  me  to  adopt  the  latter  opinion,  and  as  I 
flatter  myself  they  may  add  to  the  mass  of  useful 
facts,  I  here  republish  them  from  the  Medical 
Repository,  (vol.  v.  p.  85.)  They  are  a  sequel 
of  certain  experiments  to  the  sam^e  point,  made 
by  Mr.  H.  C.  Kunze.  The  result  of  my  expe- 
riments were  summed  up  in  the  following  Letter 

to  Dr.  MiTCHILL. 

"  New-York  HospitaU  June  22,  1801. 

^^SlR, 

^^  I  observe  the  experiments  on  the  ackllty  of 
the  pus  discharged  from  foul  and  ill  conditioned 


{     26     ) 

ulcers,  made  by  Messrs.  Kunze  and  Brovver,  in 
the  New- York  Hospital,  last  November,  have 
been  published  in  London.  They  are  contained 
in  vol.  vi.  p.  69,  70.  of  the  Medical  Review  and 
^Magazine ;  but  the  account  is  not  near  so  ample 
as  in  the  Medical  Repository,  vol.  iv.  p.  297, 
299.  At  the  end  of  the  account  given  of  these 
very  interesting  and  instructive  experiments,  is 
published  a  memorandum  of  some  trials  made 
by  Mr.  Blair  and  Dr.  Ingenkousz,  a  few  years 
ago,  in  the  Lock  Hospital,  on  syphilitic  matter, 
with  a  different  result.  These  gentlemen  con- 
cluded that  the  discharges  on  which  they  made 
experiments  were  of  an  alkaline  quality,  because 
the  litmus  paper  which  they  applied  to  the  vene- 
real pus  turned  of  a  hlueish  hue.* 

"It  strikes  me  there  must  certainly  be  some  mis- 
take in  the  recital  of  these  experiments,  or  in  the 
experiments  themselves;  for  I  never  heard  before 
that  an  alkali  would  turn  any  delicate  vegetable 
calour  to  a  blue  or  hlueish ;  on  the  contrary,  it  com- 
monly changes  vegetable  blues  and  purples  to  a 
greeUy  as  acids  turn  them  to  a  red.  The  natural 
colour  of  litmus  is  blueish,  and  in  the  experiments 
referred  to  by  Mr.  Blair,  the  matter  applied 
having  neither  an  acid  nor  an  alkaline  quality, 
which  is  often  the  case,  the  paper  was  taken  out, 
without  having  undergone  any  change  of  colour. 

"^  Med.  Rep.  vol.  iv.  p.  76. 


(     27     ) 

*^  The  inference,  therefore,  from  their  experi- 
ments is  simply  this,  that  in  the  trials  made  the  lit- 
mus paper  gave  no  evidence  of  acidity.  This  is  doubts 
less  very  true,  for  it  is  well  known  to  us  here, 
that  pus  is  not  always  acid,  but  becomes  so  only 
in  certain  circumstances.,  and  these  connected  until 
an  unhealthy  aspect  of  the  ulcer.  Considering 
Mr.  Blair^s  experiments  as  not  warranting  the 
conclusion  he  draws  from  them,  and,  when  right- 
ly understood,  actually  confirming,  and  not  con- 
tradicting those  published  by  Mr.  Kunze,  I  had 
at  first  meditated  to  end  my  observations  here, 
but  as  further  experiments  w^ere  called  for  within 
a  few  days,  I  have  made  them  on  some  of  our 
surgical  patients,  and  these  prove  as  plainly  as 
the  former,  that  pus  grows  sour  within  a  few 
hours  after  secretion  on  the  surfaces  of  malig- 
nant ulcers,  and  that  this  appears  in  scrophula  as 
well  as  in  lues  and  cancer. 

"  In  the  experiments  litmus  paper  was  employed 
as  the  test,  and  this  was  very  convertible  to  red 
by  the  action  of  acetous,  sulphuric  and  other 
acids.  To  prevent  mistakes,  I  guarded  against 
the  possibility  of  acidity  from  lunar  caustic,  red 
precipitate,  saccharum,  saturni,  corrosive  subli- 
mate, and  every  thing  else  that  occurred  to  me, 
and  dressed  the  ulcers  during  the  experiments 
with  dry  lint;  I  satisfied  myself  too,  that  blood 
was  not  the  cause  of  the  red  colour  acquired  by 
the  litmus. 


(     23     ) 

"  My  first  experiment  was  on  the  pus  of  a  vene- 
real ulcer,  on  the  hand  of  two  months  continuance. 
The  patient  had  been  three  weeks  under  treat- 
ment in  the  surgeons*  ward,  and  the  sore  was 
getting  well ;  yet  a  piece  of  the  litmus  paper  put 
in  at  ten  in  the  morning,  and  suffered  to  remain 
until  half  past  five  in  the  afternoon^,  was  consider- 
ably reddened, 

"  I  next  tried  an  old  ill-conditioned  ulcer  with 
caries  of  the  tibia.  It  had  been  under  treatment 
for  a  month,  and  was  healing.  A  piece  of  papei 
put  upon  the  fleshy  part  at  ten  A.  M.  and  taken 
out  at  half  past  five  P.  M.  was  evidently  turned 
red,  though  perhaps  a  shade  more  faintly  than  the 
preceding.  Then  a  scrophulous  ulcer  on  the  arm 
was  tried,  which  discharged  a  great  quantity  of 
pus  from  a  sinus.  It  was  of  fourteen  months  dura- 
tion, and  not  in  a  very  favourable  condition.  Paper 
inserted  at  ten  in  the  forenoon,  and  removed  at 
half  past  five  in  the  afternoon,  was  changed  red, 
and  sensibly  deeper  than  in  the  last  experiment. 

"  Afterwards  a  trial  was  made  on  a  syphilitic 
ulcer  on  a  woman's  leg,  of  seven  mionths  standing, 
and  growing  clean.  Litmus  paper  put  in  at  half 
past  eight  in  the  morning,  and  examined  at  noon, 
was  evidently  changed  to  a  red.  In  all  these  in- 
stances the  blue  colour  of  the  litmus  was  restor- 
ed by  dipping  the  papers  in  a  solution  of  carbo- 
tiate  of  pot-ash. 


(      29      ) 

*^  A  man  came  into  the  hospital  with  a  morti- 
fied penis,  occasioned  by  venereal  virus,  first  show- 
ing itself  in  the  form  of  a  small  chancre  not  larger 
than  the  head  of  a  pin,  and  having  spread,  within 
a  few  days,  over  a  large  portion  of  the  prepuce. 
This  ulcer  was  in  a  most  foul,  offensive  and  gan- 
grenous condition.  Litmus  paper  put  into  it  was 
changed  to  a  red  in  three  hours  and  an  half,  and 
the  colour  was  brighter  than  in  any  of  the  former 
experiments. 

"  In  a  case  o^  common  sore-shin,  of  eight  years 
standing,  a  paper  put  into  the  ulcer,  and  soaked 
in  its  pus  for  several  hours,  underwent  no  change 
at  all. 

^^  The  acidity  of  pus  mentioned  by  Edward. 
Home,  may  be  opposed  to  the  alkalinity  supposed 
to  be  detected  in  it  by  Adair  Crowford. 

'^  Indeed,  Sir,  the  results  of  these  and  other 
experiments  were  so  steady  and  similar,  that 
I  need  not  trouble  you  with  further  details.  The 
pus  of  certain  ulcers  appears  to  me  to  be  an 
acidifiable  basis,  and  to  attract  oxygen  from  the 
atmosphere :  it  therefore  takes  some  time  to  be- 
come acid,  though  this  is  commonly  effected  in 
the  course  of  a  few  hours.  What  modification 
of  the  septic  acid  this  will  turn  out  to  be,  I  must 
leave  to  your  consideration.  I  suppose  it  must 
be  septic  acid,  because,  when  concentrated  and 
plentiful,  it  corrodes  the  flesh,  stirs  up  hectic 


(    so    ) 

fever  in  the  individual,  and  v^hen  raised  into  gas 
from  numerous  ulcerated  surfaces  (which  are  so 
many  local  sources),  by  the  heat  of  the  living  body 
(96  or  98  Fahrenheit),  breeds  the  infection  of  jail, 
ship,  and  hospital  fevers,  to  be  communicated  to 
others  within  its  reach. 

"  It  is  remarkable  how  near  the  truth  some  great 
men  may  come  and  not  quite  reach  it.  Sir  John 
pRiNGLE,  I  observe,  found  that  an  austere  acid 
v/as  produced  by  mingling  putrid  animal  substan- 
ces with  bread  and  other  vegetables.  (Paper  v.) 
He  was  satisfied  that  the  faeces  humanse  often  con-r 
tain  an  acid.  (Paper  vii.)  He  delivers  it  as  his  con- 
viction, that  there  is  a  latent  acid  in  the  composi- 
tion of  all  bodies.  (Exp.  47.)  In  foul  ulcers  and 
other  sores,  where  the  serum  is  left  to  stagnate 
long,  the  matter,  he  says,  is  always  acrimonious. 
And  he  has  proved  sufficiently,  (Paper  i.)  that 
putrid  substances  are  not  alkaline,  and  that  alka- 
lies are  powerful  antiseptics.  Yet  the  baronet  could 
not  draw  the  conclusion  from  all  these  discoveries, 
that  putrid  or  septic  exhalations  were  acid,  nor 
that  the  pus  of  foul  idcers  zvas  an  acid;  but  we 
have  done  it  for  him,  and  shown  that  these,  like 
other  effluvia  from  filth iness,  are  the  exciting 
causes  of  malignant  and  pestilential  disease.  I 
think  it  not  necessary  to  say  more  on  the  subject. 
For  my  own  part,  I  stand  convinced,  and  I  most 
sincerely  hope  the  above  mentioned  facts  will 


(     31     ) 

tend  to  clear  up  the  doubts  of  the  incredulous,  ancl 
universally  to  establish  your  doctrine. 

"  RICHARD  L.  WALKER,  H,  S. 
*'  Dr.  Samuel  L.  Mitckill.'* 

I  afterwards  reflected  further  on  the  subject, 
and  extended  my  inquiries  to  the  discovery,  whe- 
ther the  sweat  was  ever  secreted  in  an  acid  state. 
I  have  no  reason  to  believe  it  is,  but,  on  the  con- 
trary, am  of  opinion,  that  though  it  is  possible  a 
morbid  sweat  may  be  sour,  still  generally  the 
acid  quality  of  the  sweat  is  not  produced  until 
some  time  after  secretion,  when  it  has  been  a  con- 
siderable time  exposed  to  the  atmosphere  and  has 
attracted  oxygen  from*  it.  The  rusult  of  these  in- 
quiries are  contained  in  the  following  letter  to 
Professor  Hosack. 

"  New-York  Hospital,  Nov.  16,  1801. 
''  Sir, 
"  In  consequence  of  the  publication  of  the  ex- 
periments which  I  made  in  June  last,  and  com- 
municated to  Dr.  MiTCHiLL,  on  jthe  acidity 
which  the  pus  of  venereal,  cancerous,  scrophulous 
and  other  ill-conditioned  ulcers  acquired  some 
hours  after  secretion,*  you  have  requested  me 
to  make  further  experiments  for  ascertaining 
whether  other  secreted  fluids  are  not  acid  at  the 

*  Med.  Rep.  vol.  V.  p.  85. 


I 


(     32     ) 

time  of  their  secretion,  or  whether  they  becom 
so  by  exposure  to  the  atmosphere. 

"  The  perspirable  matter  of  the  skin  was  sug 
gested  as  worthy  of  being  made  the  subject  of 
experiment. 

"  I  knew  it  was  a  common  observation  among 
washerwomen,  that  the  shirts  and  trov/sers  ol 
hard-working  men,  in  the  summer  time,  woul 
smell  sour  in  the  course  of  a  week's  wearing:: 
had  read  somewhere  of  sour  sweats  having  been 
observed  in  some  diseases,  and  I  had  heard  some 
respectable  physicians  express  a  belief  that  th( 
secretion  of  the  skin  Vv  as  naturally  and  always  o 
an  acid  quality. 

"  To  ascertain  the  truth  of  these  opinions,  I  put 
a  piece  of  delicate  litmus  paper  upon  the  skin  o: 
a  sailor  near  the  arm -pit,  who  laboured  under  an 
intermittent  fever.  He  was  just  admitted  into  th( 
Hospital,  and  was  in  a  foul  and  filthy  condition 
To  prevent  any  communication  with  the  oxygen 
of  the  atmosphere,  I  covered  the  paper  accurately 
with  sticking-plaster,  and  suffered  it  to  remain 
on  the  skin  for  twenty-eight  hours.     On  examina- 
tion, at  the  end  of  that  time,  I  found  that  it  exhi- 
bited signs  of  having  been  soaked  or  loosened  a 
little  in  its  texture,  but  had  not  suffered  any  alter- 
ation whatsoever  of  its  colour. 

"  Afterwards  I  selected  four  other  patients  in 
different  diseases,  whose  skins  were  in  a  moist 


(     33     ) 

state  from  perspirable  matter,  and  carefully  applied 
litmus  paper,  as  before  described,  to  a  portion  of 
skin  on  each  of  them ;  but  though  I  examined 
them  very  exactly,  and  asked  the  opinion  of  several 
other  persons  on  some  of  them,  I  could  not  dis- 
cover that  there  was  any  token  of  acidity.  I  am 
hence  apt  to  believe.  Sir,  that  sweat  is  not  sour 
at  the  time  of  its  secretion,  and  that  it  does  not 
become  acid  within  less  than  one  natural  day  after 
it  has  been  poured  out  from  the  vessels  which 
prepare  it.  The  presence  of  the  oxygenous  air  is, 
without  a  doubt,  necessary  to  the  conversion  of 
this  to  the  state  of  an  acid,  and  as  the  adhesive 
plaster  which  I  put  on  was  interposed  between 
the  perspired  fluid  and  the  atmospheric  oxygen, 
the  process  of  acidification  must  have  been  pro- 
portionably  retarded. 

"  In  the  case  of  seamen  and  labourers*  clothes 
long  worn,  soaked  through  and  through  with 
sweat,  exposed  for  a  sufficient  time  to  the  air, 
there  is  a  conversion  of  the  natural  secreted 
humour  to  an  acid  often  possessing  unhealthy 
qualities. 

^^  The  perspired  matter  never  becomes  veno- 
mous that  I  know  of,  or  believe,  until  it  has  been 
exposed  long  enough  to  become  oxydated :  then, 
and  not  till  then,  it  seems  to  acquire  its  pernici- 
ous and  fever-producing  qualities.  Hence  it  will 
appear,  that  v/hen  a  seaman's  chest  of  clothes,  or 


(     34     ) 

any  thing  of  that  kind,  is  found  to  contain  so  muciy| 
of  this  acid  as  can  poison  the  persons  who  are 
exposed  to  it  in  its  recent  and  undiluted  state, 
there  is  frequent  mistakes  committed  in  affirm- 
ing such  a  virus  to  have  been  imported  from  be- 
yond the  sea,  or  derived  from  distant  countries; 
for,  in  fact,  the  noxious  agent  is  ^roduccdzvithi?i  the 
chest,  and  onboard  the  vessel,  by  chemical  changes 
going  on  among  the  particles  of  secreted  matter 
inhering  in  the  cloathing  therein  contained. 
*^  I  remain.  Sir,  v^ith  high  respect, 
"  Yours,  &c. 
'^  RICHARD  L.  WALKER,  H.  S. 
''  Dr.  HosACK." 


SECTION  11. 

Of  the  Perspiration  in  a  State  of  Disease. 

HAVING  given  a  summary  account  of  the 
perspiratory  functions  in  a  state  of  health,  it  is  next 
proper  to  consider  its  morbid  conditions.  These 
may  be  arranged  in  three  divisions,  to  wit: 

I.  Impeded  perspiration; 

II.  Excessive  excretion  of  natural  sweat;  and, 

III.  Morbid  qualities  of  the  perspired  fluids. 


{     35     ) 

1.  Of  impeded  Perspiration. 

This  state  of  the  skin  is  judged  of  by  its  in- 
creased heat  and  dryness;  for,  when  the  perspi- 
'  ^^ble  matter  is  not  secreted  and  discharged  as  it 
ought  to  be  in  health,  the  skin,  ceasing  to  be  be- 
"dewed  with  moisture,  becomes  incapable  of  car- 
rying off  the  redundant  heat  of  the  body  as  fast  as 
is  necessary  and  comfortable. 

The  cases  in  which  this  takes  place  are  two- 
fold; first,  dryness  of  the  skin,  accompanied  with 
diminished  excitement  of  the  arterious  system; 
and,  secondly,  dryness,  attended  with  an  increased 
action  of  the  blood  vessels.  To  the  former  of 
these  heads  belong  the  cold  fit  of  fevers,  palsy, 
chronic  rheumatism,  syphilitic  cachexy,  and 
that  condition  of  the  skin  which  accompanies  old 
age.  To  the  latter  are  to  be  referred  the  hot  fit 
of  fevers,  acute  catarrh,  small-po::,  measles,  acute 
rheumatism,  pneumonia,  the  common  diathesis 
of  yellow  fever  and  plague,  and  that  condition  of 
the  cutaneous  surface  which  accompanies  the  in- 
cipient state  of  certain  dropsical  and  diabetic  dis- 
orders. 

When  the  skin  becomes  dry  from  foo  little  ar- 
terious stimulus,  it  can  frequently  be  relieved,  in 
some  degree,  by  external  \^  armth.  A  warm  season 
thus  affords  great  relief  in  many  such  cases,  and 
the  living  in,  or  removal  to,  a  more  southern  re* 


(     36     ) 

gion,  renders  that  benefit  permanent  to  many 
delicate  constitutions.  In  cooler  weather  the 
same  effect  may  be  produced  or  promoted  by 
warm  cloathing,  and  particularly  by  flannel  worn 
next  to  the  skin ;  and  more  powerfully  still  by 
the  stimulant  and  detergent  operation  of  the. 
warm  bath,  or  by  watery  vapours  and  fomenta- 
tions admitted  to  the  skin.  An  attempt  has  lately 
been  made  to  prom^ote  the  perspiratory  discharge, 
by  putting  an  arm  or  a  leg  into  a  convenient  ob- 
long vessel,  made  very  tight,  and  withdrawing  a 
part  of  the  pressure  of  the  atmosphere  by  means 
of  an  air  pump ;  and  this  is  said  to  have  produced 
remarkable  effects. 

Friction,  either  by  the  naked  hand  or  by  aid  of 
the  flesh  brush,  may  be  ranked  among  the  sudo- 
rific remedies,  operating  by  stimulating  the  cu- 
taneous vessels,  and  making  them,  more  promptly 
and  perfectly  perform  their  functions.     This  ope- 
ration  of  rubbing  is  rendered  m^ore  efficacious 
when  some  mild  ointment  is  at  the  same  time  ap- 
plied.    An  unguent  or  oily  application  has  the 
powers  of  softening  the  cuticle,  and  lessening  its 
hard  and  horny  stiffness;  it  prevents  the  chafing 
and  irritation  which  sometimes  arise  from  dry 
friction;  and  it  frequently  so  relaxes  spasm,  sti- 
mulates the  vessels,  and  opens  the  pores,  that  the 
sweat  flows  in  abundant  quantity.  This  is  amply 
proved  by  the  late  experiments  for  curing  the 


(      37      ) 

plague  in  Egypt  and  Asia  Minor,  bv  unction 
with  olive  oil,  which,  when  discreetly  and  suffi- 
ciently rubbed  upon  the  whole  surface  of  the 
body,  oftentimes  causes  a  plentiful  perspiration  to 
break  out,  to  the  great  advantage  of  the  sick. 
And  from  some  experiments  made,  anointing 
with  oil  promises  to  be  of  great  service  as  a  sudo- 
rific in  yeliov/  fever. 

In  the  Philosophical  Magazine  for  December, 
1798  (p.  257),  the  following  description  is  given 
from  Von  Berchtold,  of  the  manner  in  Vv^hich 
frictions  with  oil  have  been  used  at  the  hospital 
at  Smyrna  with  very  great  success.  ^'  This  excel- 
lent cure  for  the  plague  consists  in  rubbing  olive 
oil,  with  the  strongest  friction,  into  the  whole 
body  of  the  infected  person.  When  the  body  is 
thus  rubbed,  the  pores  being  opened,  imbibe  the 
oil,  and  a  profuse  perspiration  takes  place,  by 
which  the  poisonous  infection  is  again  thrown  out. 
This  operation  must  be  performed  the  first  day  of 
the  infection;  and  if  only  a  weak  perspiration 
ensues,  it  must  be  repeated  till  it  is  observed 
that  every  particle  of  infection  is  removed,  and 
that  the  whole  body  of  the  patient  is  covered  with 
a  profuse  sweat.  Neither  the  patient's  shirt,  nor 
bed-clothes,  must  be  changed  till  the  perspiration 
has  entirely  ceased.  The  operation  must  be  per- 
formed in  a  very  close  apartment;  and  at  every 
reason  of  the  year  there  must  be  kept  in  it  a  fire- 


(     S8     ) 

pan^  over  which  sugar  and  juniper  must  be  thrown 
from  time  to  time,  that  the  vapour  which  thence 
arises  may  promote  the  perspiration.  The  whole 
body  of  the  patient,  the  eyes  alone  excepted^ 
must  in  this  manner  be  anointed,  or  rather  rubbed 
over  with  the  greatest  care." 

Hence  we  understand  the  use  of  friction  and 
unguents  in  diseases  of  debility,  attended  with  a 
dry  skin;  and  where  high  stimulation  is  neces- 
sary, the  addition  of  sinapisms,  rubefacients, 
blisters,  and  cauteries  can  be  explained.  To  the 
same  head  of  provoking  a  discharge  from  the 
skin,  in  lieu  of  sweating,  can  a  part  of  the  effects 
of  setons  and  issues  be  ascribed. 

If  the  skin  becomes  dry  from  too  much  ex- 
citement, in  disorders  of  the  phlogistic  diathesis, 
it  is  a  question  of  delicacy  how  the  constitution 
ought  to  be  managed.  There  is  a  peculiar  dread  of 
cold  among  all  people  v/ho  speak  the  English  lan- 
guage.    By  a  grievous  mistake,  incidental  to  no 
other  tongue  spoken  in  the  world,  cold  is  consider- 
ed as  a  word  of  similar  import  with  the  catarrh  of 
the  Greek  physicians ;  and  by  a  most  unhappy  per- 
version and  extension  of  the  word  "  cold,"  it  has 
been  considered  by  those  v/ho  think  and  speak  in 
English,  as  the  cause  and  parent  of  almost  all  the 
diseases  of  the  human  frame.     And  conformably 
to  this  mode  of  considering  the  matter,  we  find 
almost  every  malady  referred  by  the  speakers  of 


(     39     ) 

the  English  language  and  their  physicians,  "  to 
atching  cold."  This  however  is  an  unhappy 
delusion,  and  much  toil  and  difficulty  must  be 
employed  to  shake  it  off;  though  it  may  be 
ustly  feared  whether  we  shall  ever  get  rid  of  the 
deception  entirely  until  the  phraseology  is  al- 
tered. 

But  though  the  phraseology  remains,  something 
bas  been  done  in  fact.  The  introduction  of  the 
cool  regimen  in  small-pox  has  been  adopted  after 
the  most  violent  opposition  that  the  strongest 
prejudices  of  the  great  body  of  physicians  and 
people  could  raise  against  it.  Here  cool  air  pro- 
motes perspiration,  allays  inflammation,  and  les- 
sens febrile  action.  The  beneficial  effect  of  ex- 
posure to  the  cool  atmosphere  in  what  has  been 
called  the  air-hath  is  wonderfully  salutary  and 
refreshing. 

In  like  manner  the  cool  treatment  of  yellow 
fever  and  other  violent  febrile  affections,  has  re- 
ceived of  late  the  sanction  of  the  most  correct 
and  able  practisers ;  and  the  benefit  done  to  the 
sick,  by  frequently  washing  the  whole  body  with 
cool  water,  amply  proves  how  agreeably  it  dis- 
poses the  fluids  of  the  skin  to  transpire.*  The 
cooling  regimen  is  coming  into  use  in  the  measles, 
and  with  great  advantage  to  the  patients;  for  it 

*  Dr.  Hamersley's  Lectures  on  the  Practice  of  Physic, 


(      40     ) 

may  be  observed,  that  much  of  the  mortality  o 
that  disease  is  owing  less  to  an  inherent  mahg 
nity  in  the  morbilious  poison,  than  to  the  pre 
posterous,  hot  and  stimulant  manner  of  treating 
it.     In  active  catarrh  also,  cool  air,  cool  v/ater 
cool  diet,  and  the  adoption  of  a  spare  regimen, 
are  of  Vv^onderous  service,  by  promoting  perspira 
tion,  unloading  the  blood  vessels,  and  restoring 
the  equilibrium  of  the  system;  w^hile  the  most 
pernicious  consequences  follow  the  heating,  sti 
mulating  and  violent  method  of  cure  vulgarly  em- 
ployed. Well  might  the  author  of  the  Brunonian 
doctrine  denominate  this  a  "  heat''  rather  than  a 
cold! 

From  these  facts,  and  from  the  benefit  derived 
from  cold  bathing  in  acute  rheumatism,  it  will 
be  apparent  that  the  dryness  and  huskiness  of 
the  skin  which  arise  from  too  great  excitement, 
may  be  best  rem.oved  by  lowering  the  tempe- 
rature, and  thereby  promoting  the  perspiratory 
discharge. 

Different  is  the  case  when  the  sweating  sur- 
face of  the  body  is  suddenly  exposed  to  cold  air  or 
cold  water.  Then  the  further  secretion  of  per- 
spirable fluid  is  quickly  checked,  the  vessels  be- 
come torpid,  the  functions  of  the  extreme  arte- 
ries of  the  skin  are  imperfectly  performed,  and 
a  universal  refrigeration  ensues.  In  these  in- 
stances,  severe  disorders  often  follow.     Some- 


(     41      ) 

times  almost  a  sudden  death  has  succeeded  the 
imprudent  immersion  of  a  heated  and  sweating 
body  in  cold  water.  At  other  times,  by  an  asso-» 
ciation  of  internal  with  external  morbid  actions^ 
the  lungs  have  suffered  from  the  injuries  sustained 
by  the  cuticular  surface,  or  the  intestines  have 
sympathized  with  the  malady  of  the  external 
parts;  or  the  muscles  have  become  diseased  by 
a  similar  affection,  derived  from  the  contiguous 
skin;  and  in  these  modes  have  a  deadly  torpor, 
or  pleurisy,  peripneumony,  an  enteritis  or  dysen- 
tery, a  catarrh  or  a  rheumatism,  been  excited  in. 
the  constitution  of  healthy  persons. 

Thus  may  cold  do  direct  injury  when  acting 
upon  a  sweating  surface ;  but  it  may  be  asked 
how  catarrh,  acute  rheumatism,  and  other  inflam- 
matory affections  can  be  accounted  for  without 
having  their  origin  in  cold?  The  reply  is  easy  and 
plain*  The  refrigerated  state  of  body  is  only  a 
predisposing  cause,  and  renders  the  system  more 
Hable  to  be  acted  upon  by  succeeding  heat.  Now, 
if  the  body  is  very  cold,  and  in  that  condition  sud- 
denly receives  the  action  of  great  external  heat,  it 
will  probably  be  excited  to  a  morbid  degree,  and 
coughing,  sneezing,  hoarseness,  and  perhaps  ev^en 
symptoms  of  pneumonia,  as  well  as  of  catarrh, 
may  be  the  consequence. 

The  transition  from  cold  to  heat  in  such  cases 
ought  to  be  slow  and  gradual,  that  the  stimulus 

F 


(     42     ) 

may  not  be  too  violent,  but  the  body  pfepia.f ed  for 
its  iaction  by  degrees 5  just  as  when  limbs,  noses 
and  ears  are  frozen,  it  is  well  known  that  great 
and  sudden  heat  will  dispose  them  to  gangrene 
and  mortification,  but  when  admitted  in  gentle 
and  equal  degrees,  their  recovery  to  health  is  al- 
most certain:  in  common,  therefore,  cold  is  only 
the  predisposing  cause  of  catarrh  and  the  kindred 
diseases,  and  the  exciting  causes  are  heat,  and 
other  stimulants,  such  as  gin,  ardent  spirits,  and 
the  like. 

2,  Of  the  increased  Secretion  of  Natural  Sweat. 

Labour  is  the  most  common  and  obvious  mode 
of  increasing  this  discharge.  A  working  man  is 
both  depleted  and  cooled  by  his  perspiration  and 
sweat.  To  supply  the  waste  and  loss  occasioned  by 
them  he  grows  thirsty  and  takes  drink.  The  con- 
stitution so  replenished  perspires  the  more,  and 
as  this  excreted  matter  passes  off  into  vapour  the 
sensible  heat  of  the  body  is  turned  to  a  latent  state, 
and  an  agreeable  temperature  preserved ;  thereby 
the  system  preserves  its  equipoize  of  heat.  Ex- 
cessive sweating  by  labour  thins  and  impoverishes 
the  body. 

Excessive  sweating,  though  of  a  temporary  du- 
ration, is  a  frequent  occurrence  in  intermittent 
fevers.     After  the  cold  and  hot  stages  are  past>, 


{     43     ) 

there  often  comes  on  what  is  denominated  the 
sweating  stage  of  the  fit.  In  this  the  suspended 
secretions  are  restored,  and  perform  their  func- 
tions with  such  freedom,  that  some  of  the  secre- 
tions, especially  the  sweat,  are  prepared  in  more 
than  their  accustomed  quantity.  This  plentiful 
flow  of  sweat  cools  the  body  after  the  hot  stage, 
restores  moisture  to  the  parched  skin,  and  relieves 
by  a  seasonable  depletion  of  the  vessels.  Where 
the  quantity  secreted  is  not  very  great,  sweating 
may  be  deemed  g.  wholesome  evacuation  3  but  it 
sometimes  proceeds  so  far  as  to  debilitate  and  do 
injury,  as  in  hectic  fever»    For  example: 

Hectic  fever  is  a  form  of  intermittent;  only  in- 
stead of  deriving  its  exciting  cause  from  the  ex- 
ternal air,  or  any  outward  source,  it  is  engendered 
within  the  body  itself.  On  the  surface  of  ulce- 
rated tubercles,  of  large  ulcers,  and  denuded  sores, 
there  is  often  formed  an  acid  material,  whose 
absorption  stirs  up  fever;  and  from  this  fever- 
producing  stimulous  does  hectic  fever  acquire 
its  peculiar  form  and  type,  being  but  a  modifi- 
cation of  intermittent.  The  sweat  is  produced  in 
the  same  way,  and  upon  the  same  principle  ;  but 
the  frequent  and  profuse  repetition  of  it  frequently 
weakens  the  patient  excessively  by  its  colliquative 
discharge. 

Sometimes  the  skin  is  prone  to  sweat,  without 
the  presence  of  the  febrile  action  or  of  labour. 


(     44     ) 

The  vessels  are  either  too  active  or  too  lax,  and 
pour  forth  too  great  a  quantity  of  perspirable 
matter.  This  is  so  considerable  as  to  render  the 
cloathing  of  the  persons  subject  to  it  very  v^et  dur- 
ing the  hours  of  sleep,  and  even  of  waking. 
When  long  continued  it  exhausts  the  system  by 
its  debilitating  effects,  and  renders  the  body  cold, 
chilly,  and  predisposed  to  various  more  serious 
diseases.  This  excessive  sweating,  called  EpU 
drosis,  is  the  object  of  various  medical  prescrip? 
tions,  bitters,  sulphuric  acid,  friction,  bathing, 
and  the  like. 

There  is  sometimes  a  "  cold  sweat ^^  which 
ought  here  to  be  mentioned.  This  usually  occurs 
in  diseases  of  great  languor  3  and,  on  the  approach 
of  death,  it  seems  to  be  explicable  in  this  way. 
In  a  healthy  state,  part  of  th^  perspiration  is  doubt- 
less  absorbed  into  the  body,  and  the  rest,  by  far 
the  greatest  part,  exhaled  into  the  atmosphere,  or 
imbibed  by  the  cloathing;  the  absorbed  part  un- 
questionably answers  some  valuable  purpose  in 
the  animal  economy.  In  the  case  of  cold  sweat, 
the  vis  vitse  failing,  and  the  vital  heat  diminish- 
ing, the  perspired  matter  cannot  be  completely 
turned  to  vapour,  and  therefore  remains  in  drops 
on  the  cold  skin :  at  the  same  time  the  oower  of 
the  lymphatic  absorbents  becoming  nearly  ex- 
tinct, little  or  none  is  inhaled,  and,  consequently^ 
it  remains  stagnant  on  the  surface. 


(     45     ) 

S.  Of  Morbid  Sweats. 

Sometimes  the  arm-pits  of  healthy  persons 
afford  a  foetid  and  offensive  discharge.  Negroes 
are  remarkable  for  secreting  a  rank  sweat  from 
every  pore  of  their  bodies.  It  is  said  that  sweat 
is  sometimes  of  a  phosphoric  quality,  rendering 
the  back  and  sides  luminous  when  rubbed,  and 
imparting  to  the  linen  stars  of  phosphoric  acid. 
Indeed,  pathologists  have  affirmed  that  sour 
sweats  have  sometimes  broke  out  in  the  course 
of  febrile  diseases.  At  certain  times  the  perspired 
matter  abounds  with  an  uncommon  quantity  of 
salt,  as  happened  to  a  Negro  man  in  the  New- 
York  Hospital,  whose  skin,  before  death,  WTtS 
covered  with  a  saline  efflorescence,  as  if  sprinkled 
from  a  powdering  box. 

It  is  not  necessary  to  affirm  that  acid  svv^eats 
never  happen,  but  it  is  probable  that  a  sourness, 
acquired  after  secretion,  has  been  mistaken  for  a 
humour  acid  at  the  time  of  secretion. 


SECTION  III. 

On  the  Degeneracy  of  perspired  Fluids  to  Infec- 
tion and  Pestilence. 

SANCTORIUS,  inhisMedicinaStatica,  apho- 
rism 53,  has  these  remarkable  words :  ^^Imper- 
ceptible perspiration  lightens  the  body  more  than 


(     46     ) 

all  the  sensible  evacuations  put  together;  fpi 
after  sleep  every  one  may  perceive  himself  lighter, 
without  any  of  the  sensible  secretions,  because  he 
is  really  so  by  about  three  pounds.'*  This  con- 
clusion, which  that  correct  experimenter  drew, 
was  not  a  random  guess,  but  a  fact  determined 
with  all  the  accuracy  of  the  balance. 

Such  a  vast  quantity  of  perspired  matter  con- 
stantly exhaling  from  the  skin,  would  do  little 
more  than  unload  or  lighten  the  body  if  it  went 
fairly  off.  The  human  body,  however,  is  gener 
rally  covered  with  cloathing,  which  hinders  these 
secreted  fluids  from  making  their  entire  escape. 
Entangled  in  the  woollen,  cotton,  or  linen  mate- 
rials of  which  the  garments  are  made,  they  re^ 
main  in  contact  with  the  body,  and  in  time  daub 
and  besmear  it  with  filthiness.  The  perspired; 
matter  exposed  to  the  influence  of  atmospheric 
air,  in  a  degree  of  heat  equal  to  the  human  skin, 
degenerates  into  various  new  compounds,  and 
certain  parts  of  it  turn  to  septic  or  pestilential 
matter.  Those  poisonous  compounds,  so  formed, 
re-act  upon  the  body  which  produces  the  ingre- 
dients of  which  they  are  formed,  and  become 
the  exciting  cause  of  various  diseases. 

But  as  this  matter  has  been  minutely  investi- 
gated by  Dr.  Mitchill,  I  shall  pursue  the  inquiry 
by  quoting  the  words  he  has  made  use  of  in  the 
third  volume  of  the  Medical  Repository,  p.  161 
^:\seq. 


{     4t     ) 

^^  But  this  adipose  secretion  Is  by  no  means  a 
pure  oiL  According  to  circumstances,  it  is  occa- 
sionally blended  with  phosphoiic,  sulphuric,  septic, 
and  a  surplusage  of  carbonic  matter. 

"  And  it  is  further  altered,  as  far  as  its  nature 
will  permit,  by  the  constant  transmission  of  that 

AQUEOFS    FLUID,     the    INSENSIBLE    PERSPIRATION^, 

through  the  cuticle,  and  by  the  drops  of  sweat 
into  which  it  is  sometimes  condensed;  both 
formed  by  a  coalition  of  a  portion  of  the  phlo- 
giston (hydrogen)  of  the  blood,  with  a  parcel  of 
its  oxygen,  and  this  liquid  serving  as  a  men- 
struum for  certain  other  substances.  The  ex- 
ceedingly great  quantity  of  perspired  matter  inces- 
santly passing  off  from  every  exhalant  pore  of  the 
skin,  leaves  behind,  as  it  evaporates,  some  of  its 
more  fixed,  saline,  and  feculent  parts,  along  with, 
or  upon,  the  greasy  covering  of  the  cuticle.  A 
portion  of  carbone,  phosphorus,  and  septoUj 
with,  sometimes,  an  overplus  of  oxygen,  seem 
to  accompany  this  effusion  of  the  skin,  and,  in 
some  quantity,  to  remain  behind,  after  the  water 
has  evaporated. 

"  It  was  remarked  before,  that  the  cuticle  was 
insensible,  bibulous,  and,  of  course,  exceedingly 
apt  to  grow  nasty.  How  can  it  be  otherwise? 
The  cuticle  has  neither  nerves  nor  blood-vessels, 
and  there  is  little  or  no  reason  to  believe  that  it 
possesses  organization.     It  is,  therefore,  in  strict- 


(     48     ) 

ness,  less  a  part  of  the  living  body  than  a  kind 
of  tight  shirt,  or  close-setting  tunic,  drawn  over 
the  v/hole  surface  of  the  body.  This  shirt  or  tunic  i 
of  cuticle  may  be  considered  as  a  foreign  wrap- 
per, or  piece  of  natural  cloathing ;  and,  like  every 
other  foreign  thing  which  enwraps  the  body,  is 
liable  to  become  charged  v/ith  such  substances 
as  are  excreted  from  the  true  skin  within  it. 
The  foulness  of  this  natural  shirt  is  a  frequent 
occurrence.  Almost  every  body  lets  it  get  nasty. 
When  the  nastiness  is  very  considerable,  the  poi- 
sonous or  stimulant  matter  entangled  there,  irri- 
tates or  inflames  the  organ  of  feeling,  with  which 
it  lies  in  contact,  and  produces  various  itchings, 
pimples,  eruptions,  blotches,  tetters,  sores,  &;c. 
being  a  principal  cause  of  the  distempers*  of  the 
skin.  To  a  correct  mind  a  dirty  cuticle  will  ap- 
pear to  he  a  dirty  shirt.  If  the  former  could  be 
stripped  off,  and  cleansed  in  the  wash-tub,  like 
the  latter,  there  might  possibly  be  a  convenience 
in  it.  This  is,  however,  of  small  m.oment,  since 
we  knov/  the  cuticle  can  be  well  cleansed  with- 
out being  taken  off. 

'^  The  modern  use  of  white  linen  and  cotton,  as 
articles  of  raiment,  enables  us  to  judge,  with 
tolerable  accuracy,  what  material  it  is  which 
shirts,  made  of  those  kinds  of  cloth,  and  worn 
next  the  cuticle,  receive  from  the  perspiration 
and  sweat.     What  the  garments  imbibe  must 


(     *9     ) 

have  passed  first  through  the  exhalant  arteries  of 
excretory  ducts,  then  undergone  a  further  change 
while  remaining  in  and  about  the  cuticle  or  first 
SHIRT,  and  afterwards  have  beerrtfansmittedy-by— __ 
rubbing  or  wiping,  to  the  linen  fibres  or  cotton 
filaments  of  the  second.  The  animal  matter 
which  befouls  the  outer  shirt  is  a  good  indica- 
tion of  that  which  adheres  to  the  inner:  for, 
as  clean  linen  and  cotton  become  soiled  very  soon 
by  lying  in  contact  with  any  part  of  the  human 
body,  what  they  receive  must  be  principally  de- 
rived from  the  cuticle  which  they  touch  and  ab- 
sterge. 

"  The  uncleanness  of  shirts,  drawers,  and 
STOCKINGS,  may,  therefore,  be  deemed  to  be 
matter  wiped  from  the  cuticle,  and  derived  to 
4he  cuticle  from  the  vessels  and  ducts  of  the  sub- 
jacent true  skin.  An  examination,  then,  of 
the  facts  relative  to  cloathing  grown  foul  by  long 
wearing  next  the  cuticle,  may  be  considered  as 
virtually  an  examination  of  the  cuticle  itself,  and 
of  the  excreted  matters  which  stick  to  it.'* 

It  is  unnecessary  to  make  larger  quotations 
from  Dr.  Mitchill's  paper  on  this  subject,  as 
every  one  can  have  access  to  the  Medical  Reposi- 
tory. The  Doctor  attempts  to  prove  that  yellow 
fcvcr  is  frequently  produced  by  the  accumulation 
of  the  excreted  perspiration  on  the  surface  of 
living  bodies,  and  its  condensation  into  cloathing. 


(      50      ) 

He  also  attempts  to  prove  that  from  the  local  ope- 
ration of  this  excretion  on  the  surface,  a  variety 
of  local  cuticular  diseases  may  be  produced,  and 
that  alkalies  are  the  sovereign  cure  for  their  re- 
moval. There  may  be  much  truth  in  these  ge- 
neral remarks,  which  were  certainly  suggested 
by  other  physicians  lon^  before  the  Doctor  wrote 
upon  the  subje^jt.  The  Doctor  apf>ears  to  have 
very  confused  anfi  incorrect  ideas  on  the  subjects 
which  he  generally  treats  of;  he  endeavours  to 
prove  that  this  excretion,  thus  vitiated,  is  febrile 
infection  -,  but  with  all  due  respect  to  ^o  great  an 
authority,  I  beg  leave  to  remind  the  Doctor,  that 
the  term  infection  must  always  be  considered,  in 
the  language  of  Dr.  Jacksos,  "  as  a  diseased 
anir  lal  secretion.**  In  other  words,  it  is  a  process 
of  the  living  system  under  the  operation  of  febrile 
action;  infection  and  cotttagion,  therefore,  con- 
vey the  same  idea.  The  Doctor  appears  also  to 
have  fallen  into  a  very  great  mistake,  in  sup- 
posing the  vapours  arising  from  putrid  vegetable 
and  animal  matter,  and  those  from  the  lungs  and 
surface  of  the  body  in  malignant  fevers,  to  be  pre- 
cisely the  same.  An  assertion  of  this  kind,  not 
proved  by  any  direct  experiment,  and  scarcely 
supported  by  loose  analogical  reasoning,  can  never 
gain  general  credit.  I  am  well  convinced  that 
there  is  an  essential  difference  between  the  infec- 
tion of  fc\  er  and  the  specific  infection  of  measles 


(      51      \ 

or  smali-p-ox ;  but  ik^  does  attach  u  the  terms 
infection  and  contasi'ion  a  different  meaningjr 
Fevers  mav  be  produced  by  an  accumulation  of 
the  perspired  fluids  collected  in  any  considerable 
quantity  about  the  living  system;  so  also  may 
they  be  produced  by  the  vapour  arising  from 
putrid  matter.  Nay,  we  may  go  still  further,  and 
incontestlbly  prove,  by  daily  and  repeated  expe- 
rience, that  fevers  ver\-  generally  arise  from  the 
mere  vicissitude  of  weather  in  relation  to  heat 
or  cold,  moisture  or  dr^iiess ;  yet  it  would  be  ex- 
tremely incorrect  to  call  all  these  causes  of  fever 
infections.  Chemists  have  yet  to  discover  the 
nature  of  febrile  infection,  and  of  the  specific  in- 
fections of  particular  diseases.  Were  the  perspi- 
ration of  the  skin  and  of  the  lungs  unaltered  by 
any  particular  process  of  the  living  system,  to  be 
to  commonly  the  cause  of  fever,  as  Dr.  Mitchill 
seems  to  think,  we  should  as  readily  receive  the 
infection  of  {ever  from  a  person  sweating  under 
the  use  of  sudorific  medicines  in  a  case  of  plcurisv 
or  acute  rheumatism,  as  in  the  most  malignant 
fbiTO  of  fever;  but  this  is  not  the  fact.  I  appeal 
to  the  experience  of  every  physician  for  the  truth 
of  what  I  now  assert.  In  ordinary*  cases  we 
enter  the  crowded  apartments  of  the  sick  in  jails, 
hospitals,  &c.  without  hazard  i  but  wherever 
malignant  fevers  prevail,  the  risk  of  giving  to 
the  iick  the  attentions  which  our  professional  du- 


(     52     ) 

tics  require,  becomes  moi#>-«erious.  It  is  true 
Ithat,  wherever  cleanliness,  ventilation,  &c.  can 
be  pursued  In  pure  air  and  in  spacious  apartments, 
the  infection  of  fever  may  be  entirely  lost  or 
dissipated  in  the  atmosphere ;  but  it  has  also  been 
obser\^ed  in  hospitals,  where  every  attention  has 
been  paid  to  keep  the  wards  clean,  to  supply 
plenty  of  clean  bed  linen  and  body  linen  to  the 
sick,  and  where  the  sick  themselves  have  fre- 
quently been  washed  j  that  even  under  these  cir- 
cumstances it  has  sometimes  been  very  difficult 
to  destroy  a  highly  malignant  and  concentrated 
infection.  In  such  cases  it  is  usual  to  detacb 
those  labouring  under  any  malignant  form  of 
fever  from  the  other  patients;  they  are  generally 
placed  in  distinct  apartments,  or  in  a  ward  by 
themselves,  which  is  called  a  fever-ward.  The 
lUirses,  physicians,  and  other  attendants,  may, 
from  the  power  of  habit,  resist  the  operation  of 
the  febrile  infection,  and  all  perform  their  ap- 
propriate duties  to  the  sick.  The  infection  spreads 
to  a  very  small  distance  from  the  body  of  the 
patient,  and  the  other  apartments  of  the  house 
may  be  entirely  exempt  from  it.  Under  these 
circumstances  the  other  wards  may  be  visited, 
where  there  aie  numerous  sick  labouring  under 
other  diseases,  by  persons  coming  from  a  much 
purer  air,  without  danger;  but  if  such  persons 
liquid  approach  the  sick  in  the  fever-ward>  and 


(     53     ) 

remain  near  them  even  for  a  few  minutes,  they 
will  very  generally  become  the  victims  of  a 
highly  malignant  and  infectious  fever. 

All  the  theories  and  speculations  of  chemists 
on  the  nature  of  the  pestilential  virus,  or  febrile 
contagion,  want  more  experience  to  establish  any 
one  of  them  in  general  practice.  Of  these  the 
opinions  of  Morveau  and  Carmichael  Smyth 
are  certainly  entitled  to  most  attention,  and  have 
gained  most  credit  among  the  well  informed  part 
of  the  profession  in  our  country,  as  well  as  in 
Europe.  In  the  writings  of  these  gentlemen  we 
see  correct  reasoning  supported  by  fair  experi- 
ment; they  appear  to  be  the  result  of  candid  and 
fair  inquiry ;  yet,  as  I  have  before  remarked,  more 
experience  is  required  to  establish  them. 


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